Mastering Pharmacology is one of the most complicated, overlooked, yet ESSENTIAL components of being a well-rounded, safe nurse.
One of our primary foci at NRSNG is teaching Pharmacology. While many nursing programs around the country are cutting Nursing Pharmacology from their curriculum or integrating it with other courses . . . we are doubling down on our focus on Pharmacology.
In fact, within NRSNG Academy we have several courses on pharmacology.
In this post, we are going to cover a method (system) for learning Pharmacology. After reading this post, I am confident that if you follow this system, you will become a master of Nursing Pharmacology. So sit back, grab a note pad and let’s dive in.
**FOR EDUCATORS: feel free to use the resources in this post. If your nursing program would like assistance in implementing our MedMaster Course into your curriculum please reach out to us via email.
One of the most common questions we get from the NRNSG Family is:
How should I study Pharmacology? How can I learn all of this!?
You know . . . most of the time, it feels like learning pharmacology is learning a new language.
At NRSNG, we’ve already developed many pharmacology resources (listed below), the purpose of this article is to empower you with a framework for teaching and learning pharmacology. Educators are encouraged to implement this method into the classroom setting.
NRSNG Pharmacology Resources:
- MedMaster Course
- 140 Must Know Meds Book
- MedMaster Podcast
- Nursing Medication Study Guide
- Pharmacology Cheatsheets
The S.O.C.K. Method for Mastering Nursing Pharmacology
When I was 19 I took a job in Los Angeles working with immigrants from Latin America. The majority of our clients spoke no English, and my Spanish was limited to the Taco Bell menu.
This was very frustrating because I wanted to help our clients so bad, but all I could do for the first 3-6 months was smile and nod . . . in reality I had no idea what was being said. I became intensely focused on learning Spanish. I wanted to speak as comfortably as I could speak in English.
Doing this required that I did something more than I was doing. . . . I had to engage in META LEARNING. Meta learning is defined as “being aware of and taking control of one’s own learning“.
Once I became engaged to this level, my learning exploded and people kept asking where I was from because I looked as “Gringo” as they come, but my accent was spot on.
Let’s apply this to learning Nursing Pharmacology. When you are a brand new nurse or a nurse with limited knowledge of medications, how helpful can you be to your patients?
- My concern is that limited medication knowledge is less helpful and more dangerous than anything else.
- Medication administration is one of the paramount tasks of the nurse.
- In an ICU or MedSurg setting, your patient might be taking 50+ medications.
- It’s vitally important that you understand those medications, how they interact, why they are being given, and how they should be given.
- Without that knowledge, you are like 19 year old Jon, just smiling and nodding while people talk to you.
So, rather than give you a “fix” or a couple tips for learning every medication or telling you to not worry because it is a hard task, I’m going to give you a 4 (actually 6) step process for learning Pharmacology that I like to call the SOCK Method for Mastering Nursing Pharmacology.
- For aesthetic reasons, I’ve called it the SOCK Method, but in reality it should be called the O.K.C.S. Method as that is the proper order of the steps.
- The order doesn’t matter as much as knowing the framework as it will guide all future learning. In other words, this isn’t as much a checklist of steps for learning as it is a framework for learning Pharmacology as a whole.
So here is what each letter means . . . we’ll dive in deeper below.
S: Side Effects
K: Know (Must Know)
Let’s dive in a bit more and uncover what each letter actually means and how you can apply this method to master nursing pharmacology.
S: Side Effects
I am a bit of a “Side Effect Nazi” (ask anyone I’ve precepted!). In my mind, if you don’t know the side effects of a medication you are giving, how do you know if the medication is working or if the patient is experiencing a severe side effect?
One key to learning side effects is to understand very well what the intention of the medication is in the first place . . . some of your side effects are going to be the opposite effect you were trying to achieve (a patient hypothyroidism might experience a “thyroid storm” while receiving thyroid replacement therapy.
As you are learning medications you should:
- Focus on side effects that are life threatening
- Focus on side effects of major organs
- Focus on side effects that are the opposite of intended therapy
It is possible to get stuck trying to remember 4,348 side effects of Tylenol . . . however, that is not a realistic goal! Instead focus on the handful of KEY side effects.
On the clinical floor, I will not let new nurses pass medications if they are not aware of the top/most concerning side effects they should be watching out for.
The best way to think about this is to once again go back to the ABCs. Those pesky ABCs will come back to haunt you often in your nursing career . . . you must always think of them first.
When learning pharm, it’s important to have a macro understanding of the body, the organs, and how they interact with each other. This knowledge should come from A&P and MedSurg. Ideally, a nursing student wouldn’t take Pharm until they have taken and understand Anatomy and Physiology well.
As you study medications, you should also focus on the major organs when it comes to side effects and considerations. This all goes back to the ABCs that we learn from day one of nursing school. For example, giving a CNS depressant for pain is fine, but you MUST understand how that will impact the heart and respiratory drive . . . cause we kinda need those to live. Other side effects, while important, take a back seat to the ABCs.
In general, I recommend learning medications, side effects, and considerations following this order of organs:
This keeps you focused on the ABCs. If you forget that steroids cause “soggy bones” (osteoporosis) that is far less detrimental to your patient than forgetting it will raise blood sugars or depress the immune system.
You should also have a deep basic understanding of what each system will do and why meds would be given to that system.
In Pharmacology we classify HOW a medication works, either how it WORKS or how it HELPS. These are the pharmacologic and therapeutic classes respectively.
- Pharmacologic Class: how the medication WORKS
- Therapeutic Class: how the medication HELPS
- Cimetidine (Tagamet)
- Pharmacological Class: Histamine H2 Antagonist
- Therapeutic Class: Antiulcer
I recommend learning Pharmacological Classes when learning pharm for a few reasons.
- This goes hand in hand with learning A&P and focusing on the organs. If you understand the A&P and then focus on the Pharmacological Class, everything starts coming together.
- As you understand how the body works and how the medications work within the body to alter physiology things start to click much faster.
- Most importantly, generic medication names are based on Pharmacological Classes. If you know that H2 antagoists end in -idine, as soon as you see an -idine medication on a test, MAR, or elsewhere, you know exactly what it does . . . on the other hand not all antiulcer (therapeutic class) meds end in -idine.
When learning a new medication, it is important to look at and remember the nursing considerations . . . these include:
- Administration concerns
- Patient education
- Vital information
Some things that might be included in here are: how slow to administer Zofran, how fast to administer Adenosine, pregnancy categories, telling a patient not to eat grapefruit . . . you get it.
Again, you are looking for considerations that could be detrimental to the patient, will allow them to self administer, or interfere with intended results.
As the nurse, you are the one RIGHT there with the patient administering or teaching the patient how to administer the medication.
A prescription or order does not mean you MUST give the medication. Be a clinician!!!!!!!
By this I mean you MUST use nursing judgement. You are the eyes and ears of the medical team . . . you are the one at the bedside! The physician and pharmacist are NOT AT THE BEDSIDE.
You must know your considerations and know the current state of the patients condition and make a sound clinical decision. BE A CLINICIAN!!!! #beaclinician
Don’t be a blind monkey just carrying out orders. Knowing the considerations and assessing are paramount to this.
Repetition is king when it comes to learning new information. Learning nursing pharmacology is no exception. If you were to ask me, “what is the one thing I can do to learn nursing pharmacology?” . . . my two word answer would be “DRUG CARDS” . . . make them, throw them away, and make them again . . . REPEAT.
Working through the SOCK Method, you’ve identified:
- The drugs you need to know
- The things you need to know about those drugs
Now it’s time to start reviewing those medications over and over and over (you get the point).
Many students ask me to create drug cards for them, I’m not gonna do that!! Creating your own drug cards is the best way to learn this stuff.
Here’s the problem though, most “drug card templates” are a goddamn mess. Seriously, they are so unorganized that it’s no wonder students struggle with retaining the information.
So here is what I HAVE done for you . . .
I’ve created a drug card template that is developed with the S.O.C.K Method in mind:
Here’s what you need to do . . .
- Armed with your list of Must Know Drugs, start working through this template for EACH and EVERY drug on your list.
- Print out as many copies as you need.
- Create a binder with as many templates as you have drugs on your list.
- Organize them by generic name.
- Once you’ve created a drug card for each drug, start redoing cards for the ones you are using most often.
I know what you’re thinking.
“Jon, you’re insane! I already don’t have enough time to study let alone create 6,435,689 drug cards!”
Spending time studying what REALLY matters saves you time in the end. Your knowledge of the important information grows and you become a more focused nurse.
K: Know (Must Know)
Early on in my career as a nursing student I began to notice some patterns. Some meds are given and tested on far more than others. Why is that? Is it that we just don’t give a damn about patients who take abaloparatide injections?
Of course not!
When it comes down to it, some medications are far more common, taken by more patients, in more situations, and therefore more “important” to know and be aware of. The FDA had approved 1,453 drugs as of 2014, if it were possible to know each of those drugs intimately, you would be the most amazing pharmacist in the world.
This just isn’t possible.
So here is what we have done here at NRSNG:
- Outlined the most commonly tested medications.
- Cross-referenced that with the most commonly prescribed medications.
Once you get a job in a specialty area, you should add this to the list:
- Add the most common/unique medications prescribed on your unit.
You should begin making the same lists. When you are on the clinical floor, keep a note of all the medications you are giving. As you begin to notice, week after week, that you keep giving Heparin, Insulin, Protonix and others . . . make note of those. These are the medications (and pharmacological classes) that you need to know well.
This method is known as the 80/20 principal. You will give 20% of the medications 80% of the time. And of those 20% that you give, you will administer just 20% of those 80% of the time . . . you see how it works. It’s about focusing your priorities on those things that are most important.
While you COULD try to learn every medication . . . it’s just not possible. Focus your attention on learning those that you must know as deeply as possible.
To make this a bit easier, we’ve already done the leg work on a piecing together the most common and must know medications. However, as stated above, this will vary by unit, by hospital, and by physician so you should also compile your own list.
Download the complete list of the 50 most commonly prescribed medications for free here:
We’ve also compiled a list of the 140 must know meds into a book format that also spells out some of the critical, must know information. You can view that book here:
The Correct Order:
Okay, now that we are clear on what each letter in our SOCK acronym means, I want to cover the correct order for actually working through this method so that you can become a master of nursing pharm.
- O: Organs
- K: Know (Must Know)
- C: Classes/Considerations/Cards
- S: Side Effects
To get the most from this system you should actually start with ORGANS and a solid top level understanding of A&P and ABCs. This will help to keep you focused as you move through the system.
You should then use that base knowledge to help you uncover the MUST KNOW meds using the method outlined above.
From there, you should move onto CLASSES . . . it is so important that you become comfortable with Pharmacological Classes, how they are named, and how they work in the body. If you take the time at this stage to do this . . . you will be light years ahead of your peers.
CONSIDERATIONS comes next. Become a master of nursing considerations for the drugs you give most often.
You are ready to make DRUG CARDS. Use the template offered above and take a focused study session to create a nice pharm binder that includes a drug card for each of you must know medications.
Phew . . . you’re finally ready to dive deep into the SIDE EFFECTS this is the last step in the SOCK Method for learning Nursing Pharmacology and must not be ignored. When you are learning side effects it is important to focus on the method outlined above. If you do this you will be a safe nurse who has a deep knowledge of pharm.
More and more we are seeing nursing programs integrating Pharmacology into much larger courses or cut pharmacology all together. This is a very sad and concerning trend. In order to function as a true member of the health care team, nurses must be equipped to make clinical decision. Much of our time as nurses is spent providing medications. We must understand what it is that we are actually doing.
We have developed the SOCK Method for learning pharmacology to help provide a framework that nurses and nursing students can use in learning pharm . . . ok now dive in!